The Short-Term Neurodevelopment Outcomes After Pediatric Dental Treatment Under Single General Anesthesia

General anesthetics are widely used in millions of neonates and infants for operations and medical examination every year.The safety of anesthetic has also become a growing concern.This problem directly affects the anesthesia strategic,and urgently needed to be explained.Although animal studies show the anesthetic neurotoxicity,it is confusing that the current clinical researches are not consistent.More studies are needed to investigate the anesthetic neurotoxicity and minimize the side effect of anesthetic.PART A: A Systematic Review and meta?analysis for Association Between Children Exposed to General Anesthesia and NeurodevelopmentA growing number of studies have been done to seek the relationship between general anesthesia and neurodevelopment in pediatrics.However,the conclusions are not consistent.This article explores the association between anesthesia and neurodevelopment with meta-analysis.Objective: Systematic review of the effects of general anesthesia on neurodevelopment.Methods: The currently available evidence of general anesthesia on neurodevelopment over the past 10 years were summarized by searching Pub Med,EMBASE,and the Cochrane library according to the searching strategy.Pool OR,SMD,and their 95 % confidence interval(CI)were estimated to investigate the relationship between anesthesia and neurodevelopment.The meta-regression were used to analyze the factor of times of exposure and the factor of initial exposure age for this association.Results: 25 eligible papers were included.Children received general anesthesia before age of 4 is associated with neurodevelopment disorder with the pool OR[95%CI] value of 1.23[1.14,1.32],and the pool SMD[95%CI] value of-0.05 [-0.22,-0.88].It seems that the times of exposure(p<0.001)rather than the initial exposure age(P = 0.084)is a risk factor for neurodevelopmental disorder.Conclusions: Current evidence suggests that children exposure to anesthesia,especially repeated anesthesia,is associated with neurodevelopment disorder.Repeated anesthesia for pediatric in practice should be caution.PART B: The Short-term Neurodevelopment Outcomes After Pediatric Dental Treatment Under Single General AnesthesiaObjective: To investigate the short-term of neurodevelopment outcomes after pediatric dental treatment under general anesthesia.Methods: All the subjects in our study received dental treatment under general anesthesia.A series of neurodevelopment assessments were tested 1 day before the operation and half a year after the operation.Neurodevelopment were tested according to Wechsler Preschool and Primary Scale of Intelligence fourth edition(CN)(WPPSI-IV(CN)),Adaptive Behavior Assessment System second edition(ABAS),and Behavior Rating Inventory of Executive Function-Preschool Version(BRIEF-P).The difference between pre-operation and post-operation were estimated to investigate weather neurodevelopment outcomes are associated with general anesthesia.Results: 34 Participants were included in our study with 22 males and 12 females.The average monthly age of the population was 48.1±8.6,and the average follow-up days were 188.9±8.5 days.Compared with the test before the operator,there is no significant reduction in neurodevelopment tests,including WPPSI-IV(preoperative & postoperative:110.21±7.997,109.43±7.063),ABAS(preoperative & postoperative:101.3±12.85,99.97±14.47),and BRIEF-P(preoperative & postoperative:52.39±11.50,51.45±10.90),after the operation for half a year.The same results were also found in both the...